Of the 242 unique enrollee-years that were audited, 98 had validated medical records that supported the HCC (Hierarchical Condition Categories) diagnoses submitted. The other 144 unique enrollee-years diagnoses were not supported by the medical records, because Peoples Health was not able to locate the medical records.
Starting April 5, HHS will no longer adjudicate claims submitted for vaccine administration due to a lack of funds.
In the face of such an unprecedented storm in the form of a pandemic, the need for information sharing, collaboration and rapid system development took on new urgency. There are truly remarkable examples globally of healthcare providers’ agility and innovation.
AI, augmented reality, biomedical sensors and beyond – by mapping out a clear vision now, we can widen our ambitions and improve modernization strategies to better harness the vast potential offered by technology advances.
For two years, millions of the nation’s healthcare workers have been battling the coronavirus. Many have endangered themselves as they care for those who contract COVID-19 while working in high-risk settings that expose themselves and their families.
Rich Corbridge, CIO at Boots UK and Ireland, discusses how the pandemic transformed clinician and patient attitudes toward technology and how digital tools can help improve personalized healthcare.
With the recent 88 percent reduction of the Medicare appeals backlog, HHS is on track to meet its court-ordered goal of clearing the backlog by the end of FY 2022.
Peninsula Internal Medicine, L.L.C., a medical practice located in Salisbury, Maryland, and the Estate of Candy Burns have paid the United States $286,631.33 to settle allegations that Peninsula Internal Medicine (“PIM”) and its former owner, Candy Burns, submitted false claims to the United States for medical services that were not provided.
Leonard C Boyle, United States Attorney for the District of Connecticut, today announced that WINDHAM EYE GROUP, P.C., an ophthalmological medical practice located in Windham, and its owners, DANA WOODS, M.D. and WILLIAM KAUFOLD, M.D., have entered into a civil settlement agreement with the federal and state governments to resolve allegations that they improperly employed an individual who was excluded from all federal healthcare programs.
- Highlights of the General Audit Process
- Ways a Health Plan Audit Can Be Initiated
- January – June 2022 H1 Healthcare Data Breach Report
- Customers Perceive Shortfall in Medicare Advantage Plan Coverage of Mental Health and Substance Abuse Services, J.D. Power Finds
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